On this segment of ‘NCDs and Health in all Sectors’, we will explore health in African shows and movies with Mr. Oladimeji Ogunoye, a doctoral student in the Department of English, Obafemi Awolowo University, Ile-Ife, Nigeria. His current research examines how literature-in-English intersects every other sector of life; especially with health, subjectivity and social development. In the last three years, he has researched into popular culture and how central it is in behaviour formation; focusing on how health, sexuality and subjectivity are represented in films across Africa.
Q: Why did you decide to look at health in African shows and movies?
A: I decided to examine the representations of health in African shows and movies because they have so much information that are often overlooked in research, and in drafting national health policies. Many times, apart from the censorship (which has been simply limited to flagging sexual scenes, and perhaps, more recently ‘hate speech’) and its use for political campaign, there is really no major consideration given to films when serious issues of national development are tabled generally in Africa. Also, popular culture is largely overlooked as a crucial aspect of public health, and the place of film in health decisions of people is not given adequate attention. So, I engage popular culture, especially films in order to call attention to the importance of popular culture to public health, and to national development. I believe that if African culture has long remained a pride to the continent, her popular culture also holds a major key to the continent’s development across sectors.
Q: How is public health discussed in African shows and movies, and why is it viewed or framed that way?
A: I will respond to this question from three approaches – Public health in the Society, in the movies and shows, and the place of reception.
Of course, the approach to public health in African movies and shows is an off-shoot of what happens in the society. Health in Africa is largely challenging. Apart from the problems of ineffective/inappropriate health policies, lack of infrastructure, and, inadequate remuneration/low welfare of health practitioners; there is the bigger issue of religion, tradition and orthodox medicine. All these not only reflect in African shows and movies, they also influence how and what is shown. We have more health-themed movies than shows in Africa, and funding/patronage is central to it. While popular arts (one of which is film) generally develop and enjoy wide patronage with little or no corporate or institutional backing, productions relating to formal education do not. This is why even shows that are health related are scripted in ways to fascinate and entertain, so that the audience’s attention can be retained, and constant patronage is maintained. So, movies that are health-themed employ the use of sound, music, lighting, narrative, images and settings to go with the storyline/message in order to attract, retain, and maintain audience’s interest. This way, they enjoy some level of acceptance, but then, there are still challenges here and there.
The second approach to this question is to look at the movies and the shows. While growing up in Akure town, Ondo State, Nigeria, I remember that there was a state government sponsored show, Ìlera l'oro (Health is wealth), on OSRC (Ondo State Radiovision Corporation). Among other topics, attention was given to nursing mothers, basic personal and environmental hygiene, and first aid. However, there were more tele-drama series on health at the time. A key thing about these shows and tele-drama series is the use of songs to pass messages, and help the audience remember what they have been told. While health shows are somewhat scarce and unpopular, there are documentaries on different health topics. An example is Marianne Khoury’s Zelal from Egypt, which is one of the most insightful documentaries on mental health in the country.
While most of my response will focus on Steve Gukas’ 93 Days on the Ebola disease, and MTV Shuga. a television series on sexual and reproductive health of young people, I will like to briefly list a few health-themed movies from the continent. West Africa: Imoh Umoren’s Children of Mud on rape, adolescent mothers, and unorthodox birth; Moses Inwang’s Alter Ego on multiple personality disorder, trauma, and rape; Kunle Afolayan’s October 1, on rape, sodomy, post-traumatic stress disorder; Stephanie Okereke Linus’ Dry on child marriage, adolescent parenting, rape, vesico-vaginal fistula; Kunle Afolayan’s Roti on heart disease and trauma. Southern Africa: Oliver Schmidt’s Life, Above All on HIV/AIDS, terminal disease; Darrell Roodt’s Yesterday about domestic violence, HIV/AIDS. East Africa: Peter Kawa’s Lost in Time on Mental health, Njue Kevin’s 18 Hours on the Kenyan healthcare system. North Africa: Amr Salama’s Asmaa on HIV/AIDS. There are also short films too that treat various public health issues and they mostly employ same technique with the movies.
One thing that is common to movies that focus on health is the subjectivity of each experience. The intended message determines the point of view from which the story is told. For instance, the Ebola story in 93 Days is told with special focus on the experiences of the health practitioners who were at the forefront during the Ebola outbreak. The movie itself is a tribute to all the people who died while working to make sure Ebola does not become a nationwide pandemic. This method of focusing on individual experiences, is employed also in MTV Shuga. Each character of interest is brought to focus, so that the way he/she thinks, how his/her decisions are made, and why he/she made the decisions that they made is shown to the audience. This method is aimed at generating empathy, solidarity, and interest from the viewers. The scriptwriters often come from the position of familiarity, and then creatively weaves twists and messages into the stories. This is because African movies have a tripartite role. They entertain, they reflect, and they educate. So, as far as public health is concerned in African shows and movies, these three play out. Movies and shows are basically designed to entertain. However, the content of movies and shows usually reflect the society that created it, thereby exposing audience to worlds, ideologies, and behaviours beyond them.
The third important aspect of public health discussion in African movies and shows is the reception. African shows and movies thrive on how they are received. The success or otherwise of a movie or film form informs whether and how future experiments will be carried out. Most of the public engagements of African shows and movies are through the goggles of religion and morality. So, instead of appraisal and critique, most of these shows and movies are judged. As a result, the potential of a movie or show is narrowed down to religious implications and how moral what is shown is. This is largely what determines if the shows and movies are accepted or not. The reason for this is unrelated to the sense of denial surrounding sensitive topics in the society, and the secrecy with which a topic like sexuality is treated. So, there are higher chances that the public health potential of a movie or show that does not show nudity will be easily acknowledged, while productions that treat sensitive topics are tagged controversial. For instance, the difference in the way 93 Days and Alter Ego is perceived in Nigeria points to this fact. While 93 Days have a religious, pious and upright appeal, Alter Ego explores the sensitive topic of rape, multiple personality disorder, trauma and sexual behaviour. So, 93 Days appeal to the audience’s moral judgement, and Alter Ego does not. So, one is accepted, the other is not entirely accepted, because some scenes show sex even though it is pointing to really serious public health issues. Same goes for television shows. For instance, every year, there is a renewed clamour to shut down Big Brother Naija because “it looks like soft porn.” Whereas the show has the potentials of being incredibly useful to show how young people think, the mental health conditions of these age group, and, aspirations that they have; attention is placed mostly on whether there is sex, or who had it.
So, the discussions around public health in African movies and shows are determined by the realities of the society producing the films, specific focus on subjectivity in the films and the culture of reception.
Q: Are there any ways in which the African movie and TV industry currently positively and/or negatively influences public health? And if so, how?
A: Well, African film and TV industries are trying their best. No film maker or writer sets out to write a bad script or portray health in a bad light. They merely show what they know or have the capacity to. However, the delicate nature of film is such that, every aspect of film must be carefully written, and depicted. As shown in the answer to the previous question, there are obvious serious efforts going into ensuring that different health realities are projected in films and shows. When people watch these films/shows, they learn new ways, or reinforce the old ones on how to stay healthy.
However, there is still the issue of religion, tradition and orthodoxy when public health issues are being portrayed. There are many conflicting ideologies under the three systems. Film makers in Africa often find themselves at the centre, trying to marry or make peace with the three systems. Among other reasons for this, there is also the issue of acceptance and perception, which invariably affects patronage. African members of the audience are mostly hybrids of the three belief systems. So, in order to appeal to viewers of each belief system, film makers try to marry them positively in their stories. The danger in such hybrid ideologies reflects in the help-seeking behaviour of the audience. For instance, a person going through a prolonged illness might visit the three systems in order to find a cure by all means. In reality, while each system has borrowings from the other, they hardly agree. So, viewers are left undecided and sometimes confused when they try to marry the three in real life. As stated earlier, such depictions are dangerous. It is better to screen health out, than to pass incorrect or dangerous messages around health in the movies. Like the Yoruba saying goes Emi o l’aaro (Life has no remedy), and film stands in a delicate position here.
The film media is very delicate when it comes to behaviour modification. Movies and shows thrive on shared realities and/or desire between the portrayed character(s) and members of the audience. Focus is not only on character(s) and their experience(s), viewers also get to see movies in the intimacy of their rooms, and houses via the television, phone, or video on demand platforms. As a result of this, there is a phantom intimacy, closeness and connection between the character(s) being shown and the audience(s). This is one of the ways diehard fans are made. Many times, the audience identify with the character(s), or have empathy or sympathy for the experience(s) of their character(s) of interest, even though they know that what they are seeing is fiction. In this state, the viewer’s guard is mostly weak, and, so, there is a transfer not only of message or entertainment, but of behaviour, culture, and ideology. Many times, the viewers partake in this transfer without even knowing. For instance, movies play an important, albeit subconscious role in informing how young people practice romance, dress, talk, and relate with others among other spheres of influence. So, film makers and show producers need to know that film is not just about entertainment, it is a behaviour modification platform, and it is one of the most effective.
Q: How can African shows and movies play a better role in health promotion?
A: To play a better role in health promotion, script writing and production should not be a solo effort. There must be interdisciplinarity. Simply put, movie and show Producers and Directors should employ an interdisciplinary research team to verify various aspects of their stories. Film producers should incorporate experts of the various fields that they are portraying into the production team of any movie or show. That way, they are able to pass accurate messages. This is a part of what the Censor’s Board of each country should look into. Superficial treatment of public health issues in African films or movies is often borne from the fact that there is no fact check with serious health professionals. Thus, half-baked or largely incorrect messages are passed. For instance, Akay Mason’s Elevator Baby focused on a woman who goes into labour while trapped in the elevator with a disgruntled rich kid. The different stages of labour play out, and it shows that there was research into the topic of childbirth before the movie was finally released. When the reality being portrayed in the movie is real, people will associate with it better, and any message being passed can be easily related with by the audience.
The second aspect will be about collaborations and funding. Without appropriate collaborations, government willpower, and adequate funding, film makers will be continuously forced to make do with what they have. And this could be potentially dangerous to the entire public
Q: Who are the key players necessary to better facilitate integration of health promotion in the African movie and TV industry?
A: Film makers, show producers, script writers, institutions of higher learning, censor’s board, the ministry of health, private bodies, Actors’ Guild, medical associations, Government, international collaborators, security outfits, lawyers, and the audience are all key players. Although, a production might not be able to get all, but at least most of them. Each have unique roles that they play in the equation.
Q: What African shows and movies do you recommend?
A: Well, it depends on the topic. I recommend MTV Shuga series when we are talking about the sexual and reproductive health behaviours of young people, and how their parents can effectively help. It is surprising to me that the series enjoy low patronage in Nigeria despite the importance of the message to young people. I recommend Dry when the issue of VVF is being discussed to show the reality/danger of child marriage. I recommend Children of Mud if you want to know more about street children, possible reasons that they arrived on the street, and what challenges they have to grapple with. To understand the danger that health practitioners face daily in order to keep us safe, I recommend 93 Days. As someone who studies film, I do not believe there is a bad film, I see every single production as a part of the whole society that is being portrayed. I have mentioned mostly Nigerian films, but to avoid repetition, all the movies that I mentioned earlier are but a very tiny fraction of important productions to public health development in Africa.
Q: What is the biggest barrier to promoting health in African movies and TV shows?
A: Inadequate funding. This is the main one that I will mention because many times, viewers have little idea what goes into the production of their favourite shows and movies. Usually, other barriers stem from this main one – funding. Without adequate funding, it becomes rather difficult for producers and directors to give the best. Many times, Producers want to get their production out in haste as they cannot fund the longer process of producing a good film. Also, without adequate funding, proper research cannot be carried out on different health topics before shooting the films. There are many other implications of lack of funding, but let me stop here. Although funding is not the only barrier, but it is the main one.
Q: Do you have any final thoughts you would like to add?
A: It is important that African movies and tv shows are considered as important policy tools if Africa will develop.
Thank you so much Oladimeji for your time and in-depth analysis of the public health focus in African TV shows and movies.